District-level healthcare accessibility under flood-conditioned road network disruption in Pakistan

Journal article

Floods disrupt healthcare access not only through facility damage but through road network fragmentation. This study quantifies district-level healthcare accessibility loss during the 2025 monsoon floods in Sindh and Punjab, Pakistan, using a flood-conditioned weighted road network model that reveals how network topology, rather than facility availability, governs access collapse. Satellite-derived flood extents were integrated with road network, healthcare facility, and demographic data; segments with ≥60% inundation was classified as unusable. Shortest-path distances from facilities to district headquarters were computed at 5, 10, and 15 km thresholds. Although only 0.6% of major road segments became unusable, their disruption at structurally critical locations fragmented connectivity across entire districts, producing accessibility losses disproportionate to the physical damage sustained. At the 5 km threshold, 84.8% of facilities in Sindh and 75.9% in Punjab were inaccessible, with primary care facilities most severely affected. These findings demonstrate that protecting a small number of critical road corridors could substantially preserve healthcare access during flood events.

Authors: Khan, R; Lauer, M; Marwan, M

• Publication status: Accepted
• Peer review status: Peer reviewed
• Publisher: Springer
• Journal: Spatial Information Research
• Acceptance date: 2026-05-25
• EISSN: 2366-3294
• ISSN: 2366-3286
• Language: English
• Keywords: flood impacts; healthcare accessibility; spatial network analysis; road network disruption; health system resilience; Pakistan